Surgical treatment of morbid obesity dates back to 1954 when the first jejunoileal bypass (intestinal) was done specifically for weight loss. The premise of this bypass was that patients could eat large amounts of food and the excess would either be poorly digested or passed along too rapidly for the body to absorb excess calories. In addition, intestinal bypass caused a temporary decrease in appetite which also resulted in weight loss. Unfortunately, essential nutrients were also lost in the stool. Because the effects of intestinal bypass were too difficult to predict and manage, the original form of the operation is no longer performed.
In 1969 it was noted that near-total removal of the stomach for cancer or ulcers caused patients to remain at below normal weight. This suggested that a gastric bypass could be used for severe obesity. This approach involved stapling off most of the stomach, bypassing the duodenum, and allowing the undigested food to pass along directly into the intestine. Most of the early operations eventually failed because the pouch became enlarged.
Today there are two primary surgical procedures used for achieving weight loss. One is the vertical banded gastroplasty, commonly referred to as VBG, and the other is the Roux-en-Y gastric bypass, or simply, the gastric bypass.
Gastric bypass involves significant enough risk to a patient that it is considered only as a lifesaving undertaking for morbidly obese individuals. Reported complications following the gastric bypass include postoperative complications and side effects such as marginal ulcers, wound infections, pulmonary emboli, gastrointestinal hemorrhage, renal failure, and numerous other disorders. The nature, severity, and frequency of these problems have in fact led some to doubt the advisability of the known surgical techniques for treatment of obesity. There has been, and continues to be, a need for less traumatic surgical or non-surgical techniques to treat obesity.